Parkinson's Disease Health Center

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The symptoms of Parkinson's disease change as the disease progresses. Because of this, your doctor will adjust your drugs to deal with the symptoms as they appear. Levodopa is the most commonly used drug for Parkinson's disease. It works better than any other drug used to treat Parkinson's disease symptoms and has fewer side effects. But after using levodopa for over 5 years, many people start to have problems with motor complications (times when the medicine suddenly stops working or when you have uncontrollable jerking movements). Because of this, your doctor may prescribe dopamine agonists such as pramipexole or ropinirole to delay the point at which you need to begin taking levodopa. Studies have suggested that this may delay the onset of levodopa's side effects.³ But in the longest study done, people who started treatment with a dopamine agonist had just as many problems with motor fluctuations at 14 years as people who started treatment with levodopa.¹ Your doctor may also prescribe levodopa along with a dopamine agonist.

Treatment when the condition gets worse

A person in the advanced stages of Parkinson's disease is significantly limited in movement and activity. Symptoms can change daily, and the side effects of drugs can limit their effectiveness. Your doctor may change your drug in order to deal with the symptoms as they arise.

A speech therapist can suggest breathing and speech exercises that can help you overcome the soft, imprecise speech and monotone voice that develop in advanced Parkinson's disease. Changing how and what you eat can help you overcome problems with eating. For example, sitting upright, taking small bites and sips, and eating moist, soft foods can help you avoid nutrition problems and lessen your chance of choking. Keeping your chin up, swallowing often, and not eating sugary foods can help reduce drooling.

Freezing, or motor blocks, can be dealt with through purposeful movement. Stepping toward a specific target on the ground and making your first step a precise, long, marching-style stride can help you overcome freezing episodes. A physical therapist or occupational therapist may be able to offer some helpful advice to improve your walking and reduce your risk of falling.

Other common symptoms that appear during Parkinson's disease include depression and sexual dysfunction. Talk to your doctor about ways to overcome these problems. There are medicines that can help these symptoms in people with Parkinson's disease.

You or your family members may notice that you begin to have problems with memory, problem solving, learning, and other mental functions. When these problems keep you from doing daily activities, it is called dementia. There are medicines that can help treat dementia in people with Parkinson's disease.

Surgeries such as deep brain stimulation may be done during this stage of the disease.